title: Sulfonylureas and meglitinides: historical and contemporary issues.
abstract: Insulin secretagogue therapy is commonly used in clinical practice. These agents may be utilized as first, second-line or adjunct therapy behind metformin for treatment of type 2 diabetes mellitus. Sulfonylureas and meglitinides are effective treatments, but cumulative data over decades of research raise concerns regarding universal prescribing. The role of insulin secretagogue therapy in β-cell failure, blunting of ischemic pre-conditioning, the incidence of hypoglycemia - specifically in at-risk populations, modest weight gain and the unproven link to cancer are discussed. Ultimately, many of the concerns appear to be agent and not class-specific with glibenclamide fairing the worst amongst all of the agents discussed.
authors.affiliation: Endocrinology, Diabetes and Nutrition, Medicine, University of Maryland School of MedicineBaltimore, MD, USA - sdavis@medicine.umaryland.edu.
authors.forename: E L
authors.initials: EL
authors.lastname: Lamos
authors.forename: S A
authors.initials: SA
authors.lastname: Stein
authors.forename: S N
authors.initials: SN
authors.lastname: Davis
mesh_terms: D000818:Animals; D001549:Benzamides / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000266:history; D005905:Glyburide / Q000627:therapeutic use; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism; D019194:Ischemic Preconditioning / Q000009:adverse effects; D009369:Neoplasms / Q000139:chemically induced; D018570:Risk Assessment; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D001549:Benzamides; D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; C030516:meglitinide; D005905:Glyburide